Positive end-expiratory pressure (PEEP) does not depress left ventricular function in patients with pulmonary edema

Journal Article · Sat Aug 01 04:00:00 EDT 1981 · Am. Rev. Respir. Dis.; (United States)

OSTI ID:5583917

Calvin, J E; Driedger, A A; Sibbald, W J

Researchers evaluated the effects of positive end-expiratory pressure (PEEP) on left ventricular function in 15 patients with acute respiratory insufficiency secondary to pulmonary edema with invasive (pressure; flow) measurements and radionuclide angiography (RA). Using RNA allowed a definition of the left ventricular ejection fraction (LVEF), and then calculation of the left ventricular end-diastolic volume (LVEDV), both before and after PEEP. With a mean PEEP of 14.2 +/- 1.8 cm H2O (mean +/- SD) (range, 10 to 15), a fall in the cardiac index (4.34 +/- 1.5 to 3.84 +/- 1.4 L/min/M2; p less than 0.001) was accompanied by a significant decrease in the stroke volume index (42 +/- 13 to 39 +/- 12 ml/beat M2; p less than 0.01) and pulse rate (103.4 +/- 14.3 to 98 +/- 13.5 beats/min; p less than 0.01). The decrease in the stroke volume index was primarily due to a significant decrease in left ventricular preload (LVEDV) from 85.9 +/- 19 to 71.4 +/- 21.4 ml/m2 (p less than 0.01). Simultaneously, the mean LVEF increased from 0.47 +/- 0.10 to 0.53 +/- 0.08 (p less than 0.05), despite a significant increase in the systemic vascular resistance (1,619 +/- 575 to 1,864 +/- 617 dynes . s. cm-5/M2; p less than 0.01). Researchers concluded that the use of PEEP in patients with acute pulmonary edema, to the degree used in this study, may depress cardiac output by simply decreasing left ventricular preload. Researchers were unable to produce any evidence that would support a change in the contractile state of the left ventricle as a cause of depressed forward flow with the use of PEEP.

• OSTI ID: 5583917
• Journal Information: Am. Rev. Respir. Dis.; (United States), Journal Name: Am. Rev. Respir. Dis.; (United States) Vol. 124:2; ISSN ARRDA
• Country of Publication: United States
• Language: English

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59 BASIC BIOLOGICAL SCIENCES
62 RADIOLOGY AND NUCLEAR MEDICINE
BIOLOGICAL EFFECTS
BIOMEDICAL RADIOGRAPHY
BLOOD CIRCULATION
BLOOD PRESSURE
BLOOD VESSELS
BODY
CALCULATION METHODS
CARDIOVASCULAR SYSTEM
DIAGNOSTIC TECHNIQUES
EDEMA
HEART
LUNGS
MEASURING METHODS
MEDICINE
NUCLEAR MEDICINE
ORGANS
PATHOLOGICAL CHANGES
PATHOLOGY
PATIENTS
PHYSIOLOGY
RADIOLOGY
RESPIRATION
RESPIRATORY SYSTEM
SYMPTOMS